Fear Of Disease Progression And Its Influencing Factors In Patients With Chronic Heart Failure

PurposeTo investigate the status quo of fear of disease progression in patients with chronic heart failure and explore the influencing factors of fear of disease progression in patients with chronic heart failure,so as to provide theoretical basis for formulating clinical intervention strategies to reduce the fear of disease progression in patients with chronic heart failure and improve the quality of life.MethodsThis study was a cross-sectional study.From January 2021 to December 2021,a total of 206 patients with chronic heart failure who were hospitalized in the cardiovascular department of two third-class hospitals in Jinan city,Shandong Province were selected for questionnaire survey.The survey tools included self-made general information questionnaire,disease progress fear scale,heart failure symptom status questionnaire,knowledge level questionnaire of heart failure patients,medical coping questionnaire and Disease Uncertainty Scale.Statistical methods included descriptive statistics,correlation analysis,multiple linear regression analysis,etc.,which were completed by SPSS 23.0 software.Results1.Fear of disease progression in patients with chronic heart failureAmong the 206 patients with chronic heart failure,the score of fear of disease progression in patients with chronic heart failure was(30.3±10.1),and the scores of physical health dimension and social family dimension were(15.2±5.0)and(15.1±5.7),respectively.Eighty one(39.3%)patients had a lower score for fear of disease progression.2.Relationship between demographic and clinical characteristics and fear of disease progression in patients with chronic heart failure.In patients with chronic heart failure,patients aged 60 years and above had a lower score for fear of disease progression than those aged under 60 years(t=-3.476,P=0.001),smoking patients had a higher score for fear of disease progression than non-smoking patients(t=2.415,P=0.017),and drinking patients had a higher score for fear of disease progression than non-drinking patients(t=2.241,P=0.026).Patients with NYHA class Ⅲ/Ⅳ had higher score for fear of disease progression than those with NYHA class Ⅰ/Ⅱ(t=-7.063,P<0.001).3.Relationship between somatic symptoms and fear of disease progression in patients with chronic heart failureThe patients with chronic heart failure with daytime respiratory difficulty had a higher score for fear of disease progression than those without daytime respiratory difficulty(t=-1.223,P=0.223);Patients with chronic heart failure with chest pain had a higher score for fear of disease progression than those without chest pain(t=-2.904,P=0.004);Patients with chronic heart failure with lower limb or ankle edema had a higher score for fear of disease progression than those without lower limb or ankle edema(t=-2.173,P=0.031);Patients with chronic heart failure who showed dizziness or loss of balance had a higher score for fear of disease progression than those without dizziness or loss of balance(t=-2.227,P=0.027).4.Correlation analysis of heart failure knowledge level,medical coping style,disease uncertainty and fear of disease progression in patients with chronic heart failureThe knowledge level of heart failure was negatively correlated with the score for fear score of disease progression(r=-0.307,P<0.01).The avoidance score in medical coping style was positively correlated with the score for fear score of disease progression(r=0.196,P<0.01);There was a positive correlation between scores for disease uncertainty and fear of disease progression(r=0.592,P<0.01).5.Multiple linear regression analysis of fear of disease progression in patients with chronic heart failureThe results showed that the variables that finally entered the regression model included:age(Beta=-0.102,P=0.037),NYHA class(Beta=0.360,P<0.001),chest pain(Beta=0.143,P=0.017),avoidance coping style(Beta=0.078,P=0.104),and disease uncertainty(Beta=0.491,P<0.001).Five variables explained 60.0%of the variance in fear of disease progression(adjusted R2=0.600).Conclusions1.The rate of fear of disease progression is high in patients with chronic heart failure,which suggests that healthcare provides should pay attention to the fear of disease progression in patients with chronic heart failure and implement targeted intervention measures to reduce the level of fear of disease progression,especially for young and severe patients.2.Chronic heart failure patients with chest pain have more fear of disease progression.Thus,alleviating pain symptoms in heart failure management may help reduce the occurrence of fear of disease progression in patients with chronic heart failure.3.Patients with chronic heart failure who adopt avoidance coping style have more fear of disease progression,which suggests that healthcare provides should strengthen the psychological guidance for those using avoidance coping style to reduce the occurrence of fear of disease progression.4.Chronic heart failure patients with high disease uncertainty have more fear of disease progression,which suggests that healthcare provides should strengthen health education for heart failure patients who have disease uncertainty,and then alleviate the fear of disease progression.